Smoking cessation programs

       Knowledge is power
Change takes courage

Stress levels may be         Smoking cessation classes
highest during the first     provide techniques, tools,
two weeks after quitting.    and resources for support
                             that can:
During the first few weeks   • Make cravings more
of quitting, even a small      manageable
stressor can lead to the     • Support the transition to a
                               new identity as a non-
urge to smoke.
                               smoker
Nicotine Is Special

• Nicotine is the all-time addictive drug of choice because so many people
  use it in so many different ways: to wake up, to get to sleep, to de-stress,
  to get energy, to relax.

•  There are eight patented ways to increase nicotine content by adding it to
  the tobacco after it's harvested.
•   Five of them work to add nicotine to filters and wrappers.
•   Another 12 are used to develop advanced technology to manipulate
  nicotine levels and develop new chemical variants.

     Smoking is one of the few drugs that is easily woven into daily routines.
Why smoking behavior is hard to
           change: its all in our head
Newly-abstinent smokers were shown visual cues
associated with smoking while their brain activity
was studied using neuro-imaging;

The visual cues activated the area of the brain
responsible for automatic responses- learning
habits or things we do by rote, like riding a bike or
brushing our teeth.
    Duke University Medical Center (2009, January 7). Why Smokers Struggle To Quit: New Findings. ScienceDaily.
Retrieved February 28, 2011, from http://www.sciencedaily.com- /releases/2009/01/090105175324.htm
Brains gone wild
• Suppose you always have a cigarette with
  coffee or tea – or always smoke when talking
  on the telephone, or while driving.
• The repeated pattern of behavior trains your
  brain to link these two activities.
• Over time, it becomes very hard to do one
  without the other.
Stress drives cravings.
Smoking perpetuates stress.
Long-term gain:
                   Success at quitting smoking
                   eases depressive symptoms


  Recent studies show that breaking the cycle of
tobacco use to medicate negative feelings and
depression has benefits to mental as well as
physical health.
C. W. Kahler, N. S. Spillane, A. M. Busch, A. M. Leventhal. Time-Varying Smoking Abstinence Predicts Lower
 Depressive Symptoms Following Smoking Cessation Treatment. Nicotine & Tobacco Research, 2010; DOI:
                                              10.1093/ntr/ntq213
Short-term pain:
Getting through cravings is a challenge
Nicotine is a very a short-acting drug so it has to be
                   used repeatedly.
Using any substance repeatedly – especially to
  manage emotional or psychological stress -
 produces neural pathways that have a life of
                 their own.
The Neuroscience of Bonding
When smoking is bonded to other behavior
     that behavior triggers cravings
3 Brain Regions involved with nicotine
      dependence and cravings
• BLUE: the thalamus, the brain region critical to one's ability to
  calm down when stressed.
• RED: the striatum, a region implicated in the pleasure system
  of the brain.
• GREEN: the anterior cingulate cortex, a region vital to self-
  control and concentration.




                           Credit: Image courtesy of Duke University Medical Center
Help for the craving brain
The thalamus - critical to one's ability to calm down
when stressed responds to:
• Hypnotherapy
• Mindfulness Techniques, e.g. yoga, meditation
• Anti-depressant medications
• Herbal combinations
• Acupuncture
• Exercise
The striatum deals with systems of the brain
       associated with pleasure/rewards


• Creative experiences – music, comedy, art,
  writing,
• Fun!!!
• Exercise
• Massage
• Positive social interactions
• Food
•
The anterior cingulate cortex: self-
       control and concentration
• Activities that occupy the hands, e.g. knitting,
  crafts, playing a musical instrument
• Cognitive shifts: locating one’s identity as a non-
  smoker and the relationships that support it
• Recognizing triggers and organizing ways to avoid
  them
• Cognitive planning – consciously replacing a
  smoking-related behavior with a different
  behavior
How to break a “smoking bond” before
 you quit: an example from NY Quits
• Instead of having a cigarette with your coffee or tea, have it
  before or after,
• Slowly add a couple of minutes between them over the
  next several days.
• Set a goal to wait 15 minutes between your cigarette and
  your drink.
• Drink your coffee or tea in a place where you don’t usually
  smoke, or vice-versa.
• If you drink coffee or tea with caffeine, you may want to
  gradually reduce the amount of caffeine you consume by
  switching to decaf. Feeling “jittery” is a common side effect
  of quitting smoking. If you add caffeine the side effect may
  be a bit worse.
The anterior cingulate cortex, a region
vital to self-control and concentration
 Cognitive shifts – locating a “non-smoker”
identity and relationships that support it
Social support, e.g. Nicotine Anonymous
 Knitting, crafts, playing an instrument
Breaking the “smoking bond” after you
   quit: an example From NY Quits
• Hold your cup in the hand where you used to hold a
  cigarette
• Keep your hands busy with a doodle pad, crossword puzzle,
  newspaper, to-do list or dunk low-fat cookies into your tea
  or coffee.
• Between sips, take deep breaths and savor the aroma of
  the coffee or tea.
• Don’t sit in the same seat or the same room where you
  used to sit when you were smoking.
• Stand up and drink your tea or coffee quickly and then go
  for a walk.
• Call a relative or friend or the NYS Smokers’ Quitline for
  encouragement.
What happens when we quit
    Within 20 minutes                Within 48 hours
•   Blood Pressure returns to   •   Sense of smell and taste
    normal.                         improve.
•   Heartbeat stabilizes.       •   Chances of heart attack
    Within 8 hours                  decrease.
•   Oxygen level in your            Within 3 months
    blood increases.            •   Circulation improves.
•   Mucus begins to clear out   •   Immune system
    of your lungs making            improves.
    breathing easier.           •   Possible savings of over
                                    *$400.
What happens when we quit
   Within 9 months            1 year
• Sinus congestion,        • Risk of dying from a heart
                             attack is cut in half.
  wheezing, shortness of   • Possible savings of over $1,600
  breath and phlegm          (for a pack-a-day smoker at
  production decreases.      $4.50 per pack)
• Lung Function              5 years
  improves.                • Stroke risk is reduced to the
                             same level as a non-smoker.
                           • 10 years
                           • The chances of getting lung
                             cancer are cut in half
Successful wellness programs respond to people
                where they are


Change can make a person
feel like a fish out of water.

Lifestage designs wellness programs that match
participants’ expressed degree of readiness to
change.
496 Smithtown Bypass Suite 202
      Smithtown NY 11787 631-366-4265
          lifestage_2000@yahoo.com




Contact us for a free consultation

 631-366-4265      www.lifestage.org


Jude Treder-Wolff, LCSW, RMT, CGP &
   Nicholas Wolff, LCSW, BCD, TEP

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Smoking cessation: Why Change Is Hard and What Helps To Make It Possible

  • 1. Smoking cessation programs Knowledge is power
  • 2. Change takes courage Stress levels may be Smoking cessation classes highest during the first provide techniques, tools, two weeks after quitting. and resources for support that can: During the first few weeks • Make cravings more of quitting, even a small manageable stressor can lead to the • Support the transition to a new identity as a non- urge to smoke. smoker
  • 3. Nicotine Is Special • Nicotine is the all-time addictive drug of choice because so many people use it in so many different ways: to wake up, to get to sleep, to de-stress, to get energy, to relax. • There are eight patented ways to increase nicotine content by adding it to the tobacco after it's harvested. • Five of them work to add nicotine to filters and wrappers. • Another 12 are used to develop advanced technology to manipulate nicotine levels and develop new chemical variants. Smoking is one of the few drugs that is easily woven into daily routines.
  • 4. Why smoking behavior is hard to change: its all in our head Newly-abstinent smokers were shown visual cues associated with smoking while their brain activity was studied using neuro-imaging; The visual cues activated the area of the brain responsible for automatic responses- learning habits or things we do by rote, like riding a bike or brushing our teeth. Duke University Medical Center (2009, January 7). Why Smokers Struggle To Quit: New Findings. ScienceDaily. Retrieved February 28, 2011, from http://www.sciencedaily.com- /releases/2009/01/090105175324.htm
  • 5. Brains gone wild • Suppose you always have a cigarette with coffee or tea – or always smoke when talking on the telephone, or while driving. • The repeated pattern of behavior trains your brain to link these two activities. • Over time, it becomes very hard to do one without the other.
  • 6. Stress drives cravings. Smoking perpetuates stress.
  • 7. Long-term gain: Success at quitting smoking eases depressive symptoms Recent studies show that breaking the cycle of tobacco use to medicate negative feelings and depression has benefits to mental as well as physical health. C. W. Kahler, N. S. Spillane, A. M. Busch, A. M. Leventhal. Time-Varying Smoking Abstinence Predicts Lower Depressive Symptoms Following Smoking Cessation Treatment. Nicotine & Tobacco Research, 2010; DOI: 10.1093/ntr/ntq213
  • 8. Short-term pain: Getting through cravings is a challenge Nicotine is a very a short-acting drug so it has to be used repeatedly. Using any substance repeatedly – especially to manage emotional or psychological stress - produces neural pathways that have a life of their own.
  • 10. When smoking is bonded to other behavior that behavior triggers cravings
  • 11. 3 Brain Regions involved with nicotine dependence and cravings • BLUE: the thalamus, the brain region critical to one's ability to calm down when stressed. • RED: the striatum, a region implicated in the pleasure system of the brain. • GREEN: the anterior cingulate cortex, a region vital to self- control and concentration. Credit: Image courtesy of Duke University Medical Center
  • 12. Help for the craving brain The thalamus - critical to one's ability to calm down when stressed responds to: • Hypnotherapy • Mindfulness Techniques, e.g. yoga, meditation • Anti-depressant medications • Herbal combinations • Acupuncture • Exercise
  • 13. The striatum deals with systems of the brain associated with pleasure/rewards • Creative experiences – music, comedy, art, writing, • Fun!!! • Exercise • Massage • Positive social interactions • Food •
  • 14. The anterior cingulate cortex: self- control and concentration • Activities that occupy the hands, e.g. knitting, crafts, playing a musical instrument • Cognitive shifts: locating one’s identity as a non- smoker and the relationships that support it • Recognizing triggers and organizing ways to avoid them • Cognitive planning – consciously replacing a smoking-related behavior with a different behavior
  • 15. How to break a “smoking bond” before you quit: an example from NY Quits • Instead of having a cigarette with your coffee or tea, have it before or after, • Slowly add a couple of minutes between them over the next several days. • Set a goal to wait 15 minutes between your cigarette and your drink. • Drink your coffee or tea in a place where you don’t usually smoke, or vice-versa. • If you drink coffee or tea with caffeine, you may want to gradually reduce the amount of caffeine you consume by switching to decaf. Feeling “jittery” is a common side effect of quitting smoking. If you add caffeine the side effect may be a bit worse.
  • 16. The anterior cingulate cortex, a region vital to self-control and concentration Cognitive shifts – locating a “non-smoker” identity and relationships that support it Social support, e.g. Nicotine Anonymous Knitting, crafts, playing an instrument
  • 17. Breaking the “smoking bond” after you quit: an example From NY Quits • Hold your cup in the hand where you used to hold a cigarette • Keep your hands busy with a doodle pad, crossword puzzle, newspaper, to-do list or dunk low-fat cookies into your tea or coffee. • Between sips, take deep breaths and savor the aroma of the coffee or tea. • Don’t sit in the same seat or the same room where you used to sit when you were smoking. • Stand up and drink your tea or coffee quickly and then go for a walk. • Call a relative or friend or the NYS Smokers’ Quitline for encouragement.
  • 18. What happens when we quit Within 20 minutes Within 48 hours • Blood Pressure returns to • Sense of smell and taste normal. improve. • Heartbeat stabilizes. • Chances of heart attack Within 8 hours decrease. • Oxygen level in your Within 3 months blood increases. • Circulation improves. • Mucus begins to clear out • Immune system of your lungs making improves. breathing easier. • Possible savings of over *$400.
  • 19. What happens when we quit Within 9 months 1 year • Sinus congestion, • Risk of dying from a heart attack is cut in half. wheezing, shortness of • Possible savings of over $1,600 breath and phlegm (for a pack-a-day smoker at production decreases. $4.50 per pack) • Lung Function 5 years improves. • Stroke risk is reduced to the same level as a non-smoker. • 10 years • The chances of getting lung cancer are cut in half
  • 20. Successful wellness programs respond to people where they are Change can make a person feel like a fish out of water. Lifestage designs wellness programs that match participants’ expressed degree of readiness to change.
  • 21. 496 Smithtown Bypass Suite 202 Smithtown NY 11787 631-366-4265 lifestage_2000@yahoo.com Contact us for a free consultation 631-366-4265 www.lifestage.org Jude Treder-Wolff, LCSW, RMT, CGP & Nicholas Wolff, LCSW, BCD, TEP